The incomplete efficacy of current surgical repair procedures of the tricuspid valve (TV) demands a deeper comprehension of the physiological TV biomechanics. To this purpose, computational models can provide quantitative insight into TV biomechanical response and allow analysing the role of each TV substructure. We present here a three-dimensional finite element model of the tricuspid valve that takes into account most of its peculiar features. Experimental measurements were performed on human and porcine valves to obtain a more detailed TV anatomical framework. To overcome the complete lack of information on leaflets mechanical properties, we performed a sensitivity analysis on the parameters of the adopted non-linear hyperelastic constitutive model, hypothesizing three different parameter sets for three significant collagen fibre distributions. Results showed that leaflets' motion and maximum principal stress distribution were almost insensitive to the different material parameters considered. Highest stresses (about 100kPa) were located near the annulus of the anterior and septal leaflets, while the posterior leaflet experienced lower stresses (about 55kPa); stresses at the commissures were nearly zero. Conversely, changes in constitutive parameters deeply affected leaflets' strains magnitude, but not their overall pattern. Strains computed assuming that TV leaflets tissue are reinforced by a sparse and loosely arranged network of collagen fibres fitted best experimental data, thus suggesting that this may be the actual microstructure of TV leaflets. In a long-term perspective, this preliminary study aims at providing a starting point for the development of a predictive tool to quantitatively evaluate TV diseases and surgical repair procedures.
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http://dx.doi.org/10.1016/j.medengphy.2010.08.013 | DOI Listing |
Ann Thorac Surg
December 2024
Sorbonne University, Department of Cardiovascular and Thoracic Surgery, Institute of Cardiology, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
Background: Lower mini-sternotomy offers the advantage of providing excellent visualization of the 4 cardiac cavities, allowing surgical treatment of aortic, mitral and tricuspid valves as well as any intra-cavitary procedure. Technical issues, as well as safety and echocardiographic results of this approach, are lacking. The aim of this retrospective study was to describe outcomes of lower mini-sternotomy to treat valvulopathies and other intracardiac surgeries.
View Article and Find Full Text PDFPacing Clin Electrophysiol
December 2024
Department of Cardiology, Medical University of Lublin, Lublin, Poland.
Transvenous extraction of the leads in children is associated with a higher risk of serious complications, that is why it is reluctantly performed. Unfortunately, this conservative approach has been associated with secondary complications (tricuspid valve dysfunction and bilateral venous obstruction), adverse events during lead removal procedure and recanalization and stenting of chest veins. We present a case of a 27-year-old female with a pacemaker and insertion of two new leads on the opposite side of the chest leaving the old ones in place.
View Article and Find Full Text PDFDiseases
December 2024
Department of Neurology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Noncardiogenic pulmonary edema after cardiac surgery is a rare but severe complication. The etiology remains poorly understood; however, the issue may arise from multiple sources. Possible causes include a significant inflammatory response or an autoimmune process.
View Article and Find Full Text PDFJ Vasc Access
December 2024
Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
The fibroblastic sleeve is a structure potentially enveloping any intravascular device. At ultrasound scan, it typically presents as a thin layer of variably echogenic material covering the catheter surface, which usually tends to remain into the vessel after the catheter removal. However, several case reports have documented its migration toward the heart or pulmonary artery after a central venous catheter removal.
View Article and Find Full Text PDFEur J Heart Fail
December 2024
Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Munich, Germany.
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